Top 5 conditions rheumatologists encounter

By Kristin Logee, DO  |  9/28/2017

Rheumatologists treat patients with bone and joint disorders, such as osteoarthritis and gout.

We also deal with autoimmune diseases that affect the joints and other organ systems. Autoimmune diseases occur when the immune system, which normally functions to fight infection, instead turns on and attacks the body.

Rheumatology is ever-changing as we learn more about these conditions. There is continuous research being done to better understand what causes these diseases and to find better ways to diagnose and treat them.

We now have the ability to significantly improve the quality of our patient's lives and minimize joint and other organ damage that, in the past, was often devastating.

Rheumatology is an outpatient field of medicine that deals with chronic conditions. This affords the opportunity for providers to really get to know patients and build a relationship with them over a period of months or years.

Treatment for rheumatologic diseases depends entirely on the condition being treated.

Treatments range from medications to reduce symptoms, medications to suppress the immune system, physical therapy and therapeutic injections (injections into joints or soft tissues that relieve pain and inflammation and can reduce the need for oral medication).

These are five common conditions most rheumatologists encounter:

  • Osteoarthritis: This is the most common type of arthritis and can affect people of any race or gender. It is often due to age-related joint damage from the wearing away of cartilage over time, although genetics can play a large role in determining who will develop osteoarthritis and how severe it will be. It commonly affects the spine, knees, hips and hands. There is no treatment to reverse the joint damage once it occurs. However, multiple treatments exist to improve function and decrease joint pain. Exercise and weight loss are very important in reducing symptoms and slowing the progression of osteoarthritis. There are also many medication options available to treat the symptoms and these come in many forms, including creams, patches, injections and pills.
  • Rheumatoid arthritis: This is a chronic inflammatory arthritis that occurs when the immune system attacks the body. It can affect the body in a variety of ways, but the most common manifestations are joint pain, swelling and stiffness. Rheumatoid arthritis typically affects the hands, wrists and feet, but it can affect a number of other joints. Treatment with medication is required to calm down the immune system, with the goal of preventing permanent joint damage and other complications.
  • Gout: This is a type of arthritis that results from a high level of uric acid in the body. The uric acid forms crystals in the joints, which the immune system reacts to, causing bouts of very painful, inflamed joints. It most commonly affects the great toe, although essentially any joint can be affected. Gout is treated with medication to calm down the inflammation during the acute attack. Often, additional medication is needed to reduce the amount of uric acid in the body and prevent future attacks and joint damage before they occur.
  • Psoriatic arthritis: This is a chronic inflammatory arthritis that occurs in about 15 percent of people with psoriasis (a skin condition that manifests as red-and-white scaly patches on the skin). Psoriatic arthritis is caused by the immune system attacking the joints. The disease varies greatly from patient to patient in terms of how many joints are affected, which joints are involved and how severe the symptoms are. Treatment is with anti-inflammatory medications and, in more severe cases, medications that calm down the immune system.
  • Fibromyalgia: Although fibromyalgia is not a rheumatologic condition, it is often diagnosed by a rheumatologist because the symptoms can mimic those seen in a number of rheumatologic diseases. It is a common condition, affecting about 2 to 4 percent of the population and typically seen in young and middle-aged women. Symptoms include widespread pain in the muscles and/or joints, chronic fatigue, sleep that is not refreshing and brain fog/memory difficulties. Fibromyalgia is not an autoimmune condition and no damage to the joints or muscles occurs. However, it can greatly impact quality of life. It is typically treated by primary care physicians, sometimes in conjunction with other specialists. Treatment includes exercise, cognitive behavioral therapy, medications and addressing any underlying issues including sleep apnea, anxiety and depression.

Dr. Kristin Logee is a board-certified rheumatologist. She sees patients in Health Quest Medical Practice's Hyde Park primary care office at 4068 Albany Post Road. To schedule an appointment, call 845-790-2098 (TTY: 1-800-421-1220). For more information, visit www.healthquest.org/primarycare.